首页|基于PageRank算法及Mplus因子分析探讨杨霓芝教授诊治IgA肾病规律

基于PageRank算法及Mplus因子分析探讨杨霓芝教授诊治IgA肾病规律

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目的 本研究旨在多层次分析名老中医诊治IgA肾病的临床经验,为传承中医肾病名医经验提供方法参考。方法 采集并标准化广东省中医院杨霓芝教授门诊在2010-2020年期间诊治IgA肾病患者的医案数据,并将患者分为尿血组、尿浊组及肾衰组。利用FangNet平台进行PageRank算法计算药物THScore得到不同亚组IgA肾病核心药物。通过Python(SciPy包、Clusterheatmap包)可视化证型分布规律及相应用药规律,应用Mplus软件使用加权最小二乘估计法及斜交旋转GEOMIN法进行药物处方探索性及验证性因子分析。结果 总共纳入145例IgA肾病患者,共548诊次。其中尿血组54例、尿浊组51例及肾衰组40例。基本证型有9种,含气虚证(91。79%)、血瘀证(77。01%)、湿热证(66。06%)及阴虚证(38。69%)等。总队列核心药物24种,尿血组23种,尿浊组21种,肾衰组16种,主要为益气补阳药、滋阴养血药、活血祛瘀药、清热凉血药等。IgA肾病辨证用药规律(Z-Score>0。5且P<0。05):气虚证常用药物:黄芪、山茱萸、菟丝子。血瘀证常用药物:丹参、泽兰、山茱萸等。湿热证常用药物:蒲公英、石韦、桃仁、土茯苓等。阴虚证常用药物:墨旱莲、太子参、女贞子等。根据探索性及验证性因子分析的结果,可以得出杨霓芝教授治疗IgA肾病核心药物组合因子包括:F1(菟丝子、山茱萸、黄芪);F2(白茅根、小蓟、茜草);F3(女贞子、墨旱莲、太子参);F4(泽兰、桃仁)。结论 本研究通过应用PageRank算法及Mplus因子分析,分组分析杨霓芝教授诊治IgA肾病经验,明确以"气虚血瘀、湿热阴虚"为核心证型,"益气活血、清热养阴"为核心治法的IgA肾病岭南中医诊治心得,为传承名医经验提供方法参考,促进中医药的开发利用。
PageRank Algorithm and Factor Analysis Assists the Identification of Treatment Patterns of Chinese Herbal Medicine for Immunoglobulin A Nephropathy
Objective The objective of this study was to provide methodological references for the inheritance of the experience of well-known Chinese medicine doctors in the treatment of kidney disease.Methods The study collected medical case data for IgA nephropathy,diagnosed and treated by Professor Yang Nizhi's outpatient department at Guangdong Provincial Hospital of Traditional Chinese Medicine from 2010 to 2020.The data was standardized and divided into three groups:urine and blood,urine turbidity,and renal failure groups.The study utilized the FangNet platform to apply the PageRank algorithm and calculate the THScore of different subgroups of core herbs for IgA nephropathy.The distribution pattern of syndrome differentiation and corresponding herb use regulations were visualized through Python(SciPy package,Clusterheatmap package),and the study explored and verified the drug prescription through exploratory and confirmatory factor analysis based on Pearson correlation coefficient.The weighted least squares estimation mean and variance adjusted(WLSMV)and the oblique rotated GEOMIN method were used with the Mplus software.Results The study included a total of 548 treatments for 145 patients with IgA nephropathy,with heamturia group(54 cases),urine turbidity group(51 cases),and renal failure group(40 cases).Results showed 9 basic syndromes such as Qi deficiency syndrome(91.79%),blood stasis syndrome(77.01%),damp-heat syndrome(66.06%),and Yin deficiency syndrome(38.69%).There are 24 core drugs in total,23 in the urine and blood group,21 in the urine turbidity group,and 16 in the renal failure group.These drugs mainly include qi-tonifying and yang-invigorating drugs,nourishing yin and blood drugs,promoting blood circulation and removing blood stasis drugs,and clearing heat and cooling blood drugs.The regulations for the differentiation and medication of IgA nephropathy(Z-Score>0.5 and P<0.05)were as follows:Huangqi,Shan Zhu Yu,and Tusizi were commonly used in Qi deficiency syndrome;Danshen,Ze Lan,and Shan Zhu Yu were commonly used in blood stasis syndrome;Pu Gong Ying,Shi Wei,Tao Ren,and Tu Fu Ling were commonly used in damp-heat syndrome;and Mo Han Lian,Tai Zi Shen,and Nv Zhen Zi were commonly used in Yin deficiency syndrome.Through exploratory and confirmatory factor analysis,the core drug combination factors for the treatment of IgA nephropathy by Professor Yang Nizhi were obtained as follows:F1(Tusizi,Shan Zhu Yu,Huangqi);F2(White Mao Gen,Xiao Ji,Qian Cao);F3(Nv Zhen Zi,Mo Han Lian,Tai Zi Shen);and F4(Ze Lan,Tao Ren).Conclusion This study analyzed the diagnosis and treatment experience of Professor Yang Nizhi in the treatment of IgA nephropathy by grouping,defining the core syndrome of"Qi deficiency and blood stasis,damp-heat and Yin deficiency",and the core treatment methods of"tonifying Qi,promoting blood circulation,clearing heat,and nourishing Yin"using the PageRank algorithm and Mplus factor analysis.The study provided methodological references for the inheritance of the experience of famous Chinese medicine doctors and promoted the development and utilization of traditional Chinese medicine.

Factor analysisPageRank algorithmIgA nephropathyExperience in traditional Chinese medicine

卢家言、张腊、胡晓璇、凌曦淘、于浩天、梁紫越、卢佐宸、侯海晶、卢富华、杨霓芝

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广州中医药大学第二临床医学院 广州 510006

广东省中医院/广州中医药大学第二附属医院 广州 510120

广州中医药大学公共卫生与管理学院 广州 510006

粤港澳中医药与免疫疾病研究联合实验室 广州 510120

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因子分析 PageRank算法 IgA肾病 名老中医经验

广东省科技厅科技创新战略专项广东省中医院中医药科学技术研究专项全国名老中医药专家传承工作室建设项目

2020B1212030006YN2019ML06E52904

2024

世界科学技术-中医药现代化
中科院科技政策与管理科学研究所,中国高技术产业发展促进会

世界科学技术-中医药现代化

CSTPCD北大核心
影响因子:1.175
ISSN:1674-3849
年,卷(期):2024.26(3)
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